Abstract
Excessive gestational weight gain is related to many complications (both maternal and fetal), such as macrosomia. The most common complications in macrosomic fetuses include: increased risk of intrauterine death, need for intensive care, fractures, neonatal hyperbilirubinemia, paralysis of the brachial plexus and obesity in childhood and adulthood. The aim of this study was to evaluate the association between gestational and fetal weight gain and the incidence of macrosomia in two maternity hospitals. Cohort study in two public maternity hospitals in Goiânia, Brazil. This was a cohort study on 200 healthy pregnant women with normal body mass index, divided into two groups: one with normal weight gain and the other with excessive weight gain during pregnancy. The cohorts were similar regarding maternal age, per capita income, schooling level and reproductive behavior. The fetal weight was greater in the cohort with excessive maternal weight gain (3,388.83 g ± 514.44 g) than in the cohort with normal weight (3,175.86 g ± 413.70 g) (P < 0.01). The general incidence of macrosomia was 6.5%: 13.0% (13 cases) in the cohort with excessive maternal weight gain and 0.0% (0 cases) in the cohort with adequate weight gain. Excessive maternal weight gain was associated with increased fetal birth weight and incidence of macrosomia.
Highlights
Weight gain during pregnancy has always been a matter of great concern for most women and obstetricians
The study included 200 pregnant women who had been hospitalized for childbirth in two public maternity hospitals in Goiânia, Brazil: one of them secondary and the other, tertiary
The variables of total weight gain and final body mass index (BMI) presented significant differences (P < 0.01), as expected, because the postpartum women were divided according to their weight gain for their participation
Summary
Weight gain during pregnancy has always been a matter of great concern for most women and obstetricians. This concern exists because gestational weight gain is related to many complications, both maternal and fetal.[1,2] Macrosomia is a major fetal complication, consisting of cases of infants born weighing more than 4,000 g, regardless of the gestational age.[3] This large weight is associated with complications for both the mother and the child. The most common complications in macrosomic fetuses include: increased risk of intrauterine death, hypertrophic cardiomyopathy, need for intensive care, shoulder dystocia, humeral and clavicle fractures, meconium aspiration, hypoglycemia, neonatal hyperbilirubinemia, paralysis of the facial and brachial plexus and obesity in childhood and adulthood.[4,5,6,7] For mothers, the most common complications include: increased risk of cesarean section, cephalopelvic disproportion, prolonged labor, soft-tissue lacerations and postpartum hemorrhage.[4,6]
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